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SLMC should look inward and outward
View(s):Justice Yasantha Kodagoda urges 100-year-old regulator to examine itself and improve its efficacy, efficiency and integrity in its ‘dual role’ of protecting the public interest and the best interests of the medical profession
By Kumudini Hettiarachchi
While public concern is growing against alleged malpractices committed by medical professionals, there are accusations that the Sri Lanka Medical Council (SLMC) is slow in its investigations against such complaints and “at times” perceived to favour such accused professionals, a respected Supreme Court Judge said yesterday.
Justice Yasantha Kodagoda, speaking on ‘Strategies for Addressing Malpractices in Healthcare Systems’ at the centenary academic sessions of the SLMC held at the BMICH, Colombo, stressed that the SLMC is also accused of adopting a protectionist attitude towards those facing alleged malpractices.
“These concerns are not accusations by me, nor are they claims backed by empirical evidence. However, we cannot overlook the reality: that these views are deeply held perceptions by knowledgeable segments of the community at large,” he told the audience comprising medical administrators, specialists, doctors and officials.
He urged the 100-year-old body to examine whether the SLMC could have done better (over the years) and (now) improve its efficacy, efficiency and integrity in its dual role of protecting the public interest and the best interests of the medical profession.
Justice Kodagada stressed on the legal and ethical obligations of the profession which include respect for patient autonomy (obtaining consent and confidentiality of patients); the principle of beneficence (acting in the patient’s best interests and only doing good to the patient); the duty of non-maleficence (not doing any harm to patients); providing professional and competent medical care; compliance with statutory regulations; and refraining from any disreputable conduct.
Committing a breach of these rules would not only endanger the interests of patients and the medical professional but also erode public trust and confidence in the medical profession, which “in turn would affect the very foundation of effective healthcare”, he said.
Suggesting a review of outcomes of investigational and inquisitorial proceedings of the SLMC, he recommended that the SLMC should commission an empirical research based on an exit survey and the conduct of randomly-selected case studies.
Reform, he argued, should not be seen as an admission of blame or a plea in mitigation, rather it should be seen as a “reaffirmation of principles which you espouse and your integrity as being leaders of the medical profession”, adding that probes into alleged malpractices by the SLMC are quasi-judicial functions.
Justice Kodagoda recommended the following: setting up a Complaints Secretariat empowered to receive formal complaints and act even on whistleblower information and intelligence reports and consider credible media reports; establish an independent Investigations Unit; and categorize complaints by the severity of the complaints.
Neutrality and representation, he suggested, can be strengthened by constituting inquiry panels that include non-medical professionals; exclude elected SLMC officials from disciplinary panels; allow complainants – at inquiries – to be represented by lawyers who can question witnesses; and ensure binding timelines from fact-finding to final adjudication.
“Broaden the available sanctions (against guilty practitioners) – currently limited to erasure suspension by the Registrar – to include public censure by ‘naming and shaming’ and written warnings, among other matters,” he urged.
He said if the investigations and inquiries by the SLMC improve and restore public confidence, it is possible that aggrieved parties would opt to come to the SLMC instead of seeking litigation in the District Court. “… this would be much more desirable than having medical practitioners hauled up before courts and getting entangled in multi-tiered litigation which is time consuming, stressful, expensive and risky,” Justice Kodagoda noted.
Full speech of Judge of the Supreme Court Justice Yasantha Kodagoda, PC
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